New Delhi: The National Medical Commission (NMC) is set to release detailed guidelines related to the much-anticipated National Exit Test (NEXT) within the next two-three weeks, senior officials in the medical education regulator told ThePrint.
The examination, which will replace final-year university-level MBBS examinations, the National Eligibility cum Entrance Test (NEET) PG and the Foreign Medical Graduate Exam (FMGE), is set to begin from 2024, officials said. The NMC has approached the government with a request that AIIMS conduct the exam.
In draft guidelines released in December 2022, the majority of items in NEXT “shall test higher level comprehension, analytical skills and clinical problem-solving that are aligned to competencies”, to ensure the “assessment of higher domains of medical learning”.
All students in the final year of MBBS, and those who study MBBS outside India and wish to get a licence to practise in India, will need to take NEXT, which will be held in two parts.
The first part (or NEXT 1) will replace university-level final examinations.
According to the guidelines, the “step 1 format is intended to discourage rote learning by the medical students”.
“Case vignettes/clinical case scenarios shall be the overwhelming pattern of examination,” the guidelines said.
Clearing this step will be the basis for provisional registration with medical councils, which is needed for the one-year mandatory internship.
This test will be a multiple-choice paper with questions from medicine, surgery, obstetrics and gynaecology, paediatrics, ENT, and ophthalmology.
The second part (or NEXT 2) will be a practical paper that will be held after students have completed their internships. It will focus on assessing clinical skills. The test will cover different clinical subjects or disciplines, including medicine and allied disciplines, surgery and allied disciplines, obstetrics and gynaecology, paediatrics, otorhinolaryngology (study of ENT diseases), ophthalmology, orthopaedics, and physical medicine and rehabilitation.
The test will be clinical-case-based — It will include simulated cases or patients aimed at evaluating practical or clinical skills, clinical decision-making and communication skills expected of an Indian medical graduate, according to an official attached with the undergraduate (UG) board of the NMC.
The NEXT tests will also be the basis for preparing a merit list of all examinees, which will be used in allotting them broad speciality PG seats in medical colleges.
Universities, however, will continue to test the students separately for viva-voce or clinical skills, which can be seen as preparatory evaluation for NEXT. However, whether or not the score from this examination will be included in the final NEXT score will be clear only when the final guidelines related to the exam are issued by the NMC.
ThePrint reached NMC spokesperson Dr Yogendra Malik by phone for his comments on the pattern of this examination but could not get a response from him.
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Why has NEXT been planned
NMC officials told ThePrint that the objective of the test, which was mentioned in the NMC ACT, 2019, was to bring uniformity in summative evaluation across the country — to ensure the minimum common standards of education and training of a medical graduate are maintained.
Dr Vedprakash Mishra, who was the chairman of the UG board under the erstwhile Medical Commission of India, said NEXT may have better parameters to test the competence of MBBS students.
“But it’s high time NMC comes up with detailed guidelines related to the examination because the students will need time to adapt and prepare for the new format,” he told ThePrint.
NEXT intends to be more holistic than the current MBBS final-year examination that focuses mainly on what is taught in the last year of the course, said Dr Aviral Mathur, president of the Federation of the Residents Doctors Association (FORDA).
According to Mathur, the current medical education sector is marred with a rote-learning system that may change after NEXT is introduced.
“For the majority of final-year MBBS students, the focus now is clearing NEET PG, which is totally theoretical and hence they give more time and effort in coaching institutes and not on clinical training which is the mainstay of training as a doctor,” he said.
“So the introduction of NEXT may be a good and welcome step for the medical sector even though it will hit the coaching industry hard,” he told ThePrint, adding that NEXT will be more in line with how final-year MBBS students are tested in most of the developed countries.
(Edited by Sunanda Ranjan)
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